Pretransfer CT scans are frequently performed, but rarely helpful in rural trauma systems

Background: Rural trauma patients often undergo workup prior to transfer to a trauma center. Repeat and redundant imaging at the trauma center is common. Methods: Two hundred consecutive adult trauma patients transferred to a regional trauma center were retrospectively evaluated. Results: 197 patients met criteria. 152 underwent CT scan prior to transfer and CT was the indication for transfer in 88 patients (44.7%). One intervention was performed as a result of CT imaging. 84 patients (55.3%) received repeat CT imaging. There were no statistically significant differences in rates of CT imaging at the outside facility based on injury severity, mechanism of injury, or age. The most common reason for repeat CT scans was incomplete initial imaging. The ability to obtain initial imaging was not a significant factor. Conclusions: Repeat CT imaging in transferred trauma patients is very common. The majority of reimaging is done for incomplete initial imaging. Rural trauma systems may benefit from improved protocols for more efficient care. (C) 2017 Elsevier Inc. All rights reserved.